I had a run-in with my therapist yesterday

I had a run-in with my therapist yesterday. I was talking about having a lot on my plate with a daughter going off to college soon, a Mom needing cataract surgery and me not knowing for a week or so about a brain tumor and whether that required follow-up with the neurologist. Thankfully it does not.

Where my therapist and I disagreed was whether I had a lot on my plate. It is true my daughter is a stellar student and good athlete. So she is likely to get into some if not several colleges of her choice. But, that does not mean my feelings on her behalf don’t include anxiety. I was diagnosed with bipolar while in college — so that makes me worry about her.

My therapist also reminded me that my sister is the point person for my Mom’s cataract surgery and there is very little for me to do there. From my point of view it is difficult to have my Mom age, it is difficult in having to set limits on how much I can help with her care because of the bipolar (like driving across town at 5:00/5:30am under heavy sedation with meds). It is also stressful for me to see my Mom as she insists until recently on driving herself and I don’t feel that is safe.

The MRI for a brain tumor was stressful because I did not know if I would need brain surgery – literally.

My admiration for my therapist is at a low point. Rather than acknowledging all these stressors, she basically said I did not have a lot on my plate and I should be doing better. She texted me that she thought I had enormous difficulty managing my own life and to stop trying to manage other people instead of managing my own struggles.

This is the first time in 13 plus years where my therapist in my view made the wrong call. If I were in a wheel chair, the doctors would not necessarily believe I should walk again but that I should be making the most of my life albeit in a wheelchair. For the first time in 13 years, I feel my therapist just “doesn’t get it.” I feel she doesn’t get it that anxiety can be really rough even if it looks like things on the outside are pretty much handled. The anxiety doesn’t necessarily go away when life’s challenges are getting managed one way or another.

Has anyone had this kind of fall-out with their therapist or their doctor? Any ideas on how best to move forward?

Back in 2004/2005 I was diagnosed with a brain tumor

During a routine MRI after my daughter was born, a frontal meningioma was found – that is a small tumor in the brain sac likely benign. I was told at the time not to worry about it. In 2013, I asked the doctor specifically if follow-up was needed. He said no unless there were new symptoms. For about the last two years, I have been experiencing additional anxiety and short-term memory loss. I am unsure whether these are signs of the bipolar condition progressing with age or are symptoms of the meningioma pressing on the frontal lobe.

Friday, I had an MRI of the brain and should know the results next week. There is a part of me that is hoping it is pressure on the frontal lobe so that once removed my anxiety and memory loss should be better. It is craziness to think that way, but there you have it.

Some days

Some days my anxiety gets the best of me. I have to forgive myself for this and strive again to do better in the future.

I have been journaling my walking and my anxiety levels and it does appear anxiety is worse if I don’t get a walk in. Which comes first the chicken or the egg – I am not sure. Do I feel more anxiety because I have not been on a walk? Or do I not go on a walk because I am feeling anxious?

In any case, the addition of walks to my daily routine is favorable and appears in general to have favorable outcomes – with today being an exception.

Today though I could not let go of my anxiety about my daughter’s wellbeing. This comes at a time when my mother is going in for cataract surgery and I can’t be there because it involves driving across town at 5:00am when my evening meds are still strong in my system. I have had to say no to my ability to pick up my Mom at 5:30am to drive her to the hospital at 6:00am.

This makes me feel guilty that I cannot care for my Mom. It makes me aware of my own limitations in terms of being able to get outside of my regular routine. I am good with routine – horrible without it. I know I am taking care of my health and safety and the safety of others, but I still feel inadequate about it.

To boot, the anxiety about my Mom seems to overflow into anxiety about my daughter and vice versa. I guess you could call this poor boundaries setting at the moment. Realizing they’re not there or not strong — the boundaries — makes me feel even more inadequate.

All in all, I feel like chucking this up to a bad day. Tomorrow will be better I hope and maybe I will go on a longer walk rather than just a short one.

A way toward stigma reduction?

A blogging colleague of mine have been talking a little bit about stigma reduction associated with keeping mental illness symptoms associated with the illness itself rather than with the person. For example, the anxiety that I experience is a feature of my bipolar illness rather than some character defect or short-coming of my person. What if we were to try to represent and talk about mental illness symptoms as being features of the illness or diagnosis itself rather than characteristics of the person or the patient? By way of example, we do not think a breast cancer survivor is cancerous. Instead we say she has had cancer and fought it and is still fighting it and/or is in remission. The disease and its symptoms are not synonymous with the patient. In fact with cancer it is the other way around. People always talk about those people who are able to beat the illness cancer — it it not a part of who that person is but rather a fight to fight and to win and to overcome.

So why do we think of mental health symptoms as somehow the failure of the person experiencing the symptoms such as anxiety, depression, PTSD or some form of psychosis? When it’s mental we tend to assign the symptoms to the patient rather than to the illness. This person is anxious. This person is depressed. This person is psychotic. This makes overcoming the stigma of mental illness even tougher.

So what would it look like if we started talking about mental illness symptoms as part of the illness rather than part of the person experiencing them? It might make us more inclined to believe that getting over anxiety or depression or PTSD or psychosis is a matter of the treatment of the illness rather than the integrity of the patient or the person experiencing the symptoms.

What do you think? Do you think mental health patients are asked “to own” their symptoms in a way that cancer patients are not? Do you feel mental health stigma could be reduced if we were to more often disassociate mental health symptoms from the person experiencing them? Could mental illness be considered a challenge to fight and/or to get through like a cancer but not the result of some character defect on the part of the patient? Do we need ways of talking about mental health that include giving credit for actively working to keep symptoms under control and/or having them be in remission for a time? Do we need ways of talking about successes we have had in combatting our mental illness diagnoses even if those troubles still exist for us on some level? What of all this might help to address the stigma of mental illness?

Anxiety is a bully

I have been journaling since March 2021 about strides I am making in practicing yoga or walking on a regular basis. A week or two ago, I decided to include journaling about my anxiety in the same log. Once I started writing about my anxiety, it was as if I could not stop.

I called my anxiety a bully in that it instills pain wherever it goes. I called my anxiety cancerous in that the anxiety causes good health to go bad. I wrote and wrote and wrote about anxiety not being a friend but being a bully and how there was no room in my home for a bully. I do not allow bullying to occur in the neighborhood or at school, so why would I accept bullying at home?

I know I don’t always have control over my emotions and that is why I have a diagnosis of bipolar, but it is soooo helpful to be able to call out anxiety as a bully and think of it as something that is pervading my home rather than a feature of the bipolar I just have to accept. It is true I cannot control the anxiety when it occurs, I can only control how I respond to it when it does occur. But calling it a bully somehow helps me to think of the anxiety as “other than” and not me. I am not my anxiety. I am not my diagnosis. I am not my bipolar. My anxiety exists as a bully as part of my illness. I can call it out for what it is and I can tell it off and I can tell it it is not welcome in my person, in my home, or in my relationships with family and friends.

Does anybody else have coping mechanisms for anxiety that seem to help by differentiating the anxiety from the person experiencing it? Is it helpful to you too to think of anxiety as a bully to be kept at bay?

I Wonder

This afternoon I have had a strange thought. What if I were to visualize all the times I have been anxious about something (like in a bar graph) and compare that with the number of occasions that something that I was anxious about really occurred.

I have not done this exercise before, but I would guess every day I have an anxiety bar graph of at least a 5 or 6 or 7 or an 8 on a scale of one to ten (ten being the worst). I would also bet that there is a one in fifty chance that something I was/am concerned about will present itself as a reality. And that reality if it presents would probably be a one or a two on that same scale from one to ten.

By choosing to create a numeric or visual graph of my anxiety, I am not trying to minimize the anxiety I experience at all, because it can be quite debilitating. What I am trying to do is give myself a visual of how severe the anxiety is as contrasted with whether that anxiety I experience is ever tied with an actual anxiety-premeditated outcome.

I guess you could say I am trying to rationalize my anxiety and put it into perspective in terms of how often the incident I am worried about actually occurs. I hope the result will be that I am able to talk down myself from a high anxiety event by recalling how many times my anxiety is NOT tied with an actual stress induced event. Ie. I would like to keep myself honest as to what percent of the time that I am worried actually results in a prior perceived stress event.

Just out of curiosity, what techniques do you use to talk yourself out of anxiety? Is that working for you? What else is important to consider in trying to mitigate your anxious feelings?

Just how delicate things are

I accidentally took my morning meds two or three hours later than usual yesterday. This sent me into an anxiety tailspin. I had no idea my reaction to my meds would be so time sensitive — that a two or three hour delay would have dire consequences. Well it did. I went into a full blown panic attack and in the process extended my anxiety to my lovely 17 year old daughter. This is so totally not fair to her. BIG lesson learned for me is that schedule DOES MATTER when taking psych meds. Also BIG lesson learned is that I need to forgive myself and ask for apologies from my daughter for extending anxiety toward her instead of the love and support she deserves.

Have you ever forgotten to take meds on time and suffered the consequences? Did you have to forgive your self in the process? And ask others to forgive you too?

My Sojourn through Bipolar Illness – Airports Then and Now (reposted)

Follows Fear of Flying post

As you may understand, for years if not decades after this event at the airport (see Fear of Flying post) , I have had an intense fear of flying.  Every time I go to the airport I feel the original anxiety of that day in February 1985.  The intercom voice announcements seem to echo off the walls and the floors in some surreal fashion.  The lack of windows to the outside leaves me feeling claustrophobic always.  In the early years, this meant I had to be escorted by family to the runway gate if I were traveling alone.  (This was before the days of post 9/11 security checks.)   Years later even if I am traveling with family, I tend to be hyper aware of safety issues at all times when I am at an airport. My thoughts become more elevated and I am prone to high anxiety.  Strangely (or logically) enough these fears largely take place at the airport itself and seldom revolve around safety issues pre-flight or mid-flight while on the plane.  I am not very fearful once I am on the airplane or in flight.  The anxiety is almost always associated with being in the airport and feeling unsafe.  Gladly, my husband is also not fond of flying, so we tend to make marathon drives for our summer and family vacations. 

As a side note on airports and airport travel, I tend to have a very hard time with changing time zones when I am flying.  When I am traveling by car or by train this is not so much the case as the time change is gradual.  Because of this time zone change difficulty, I largely avoided flying to Europe for almost thirty plus years.  Even a flight from Baltimore to San Francisco was difficult in that I would experience a three-hour time change and all the difficulties associated with that, particularly impacts on sleeping.  In the last few years, I have progressed through my fears and my sleep issues of changing time zones and have traveled to Europe twice – once was for a conference in Zurich, Switzerland in July 2012 and once was for a wedding and a conference in the United Kingdom in July 2013.  Thanks to Melatonin as prescribed by my psycho-pharmacologist, I was able to make these trips with relative ease in the area of jet lag and adjusting sleep cycles.

I am very thankful that my psycho-pharmacologist as an MD was open to prescribing a relatively non-traditional form of medicine for jet lag.  This option worked beautifully for me and has given me hope that overseas travel is no longer a huge worry or huge hurdle to overcome.  In general, I am very blessed to have care givers for my bipolar illness who bridge traditional medicines and their prescription with alternative medicines such as Melatonin. 

Dear Reader,

Dear reader I am writing to ask you a question. What happens after a person has had some reconciliation of the fact that he/she was very much abused as a small child? If this doesn’t pertain to you, please disregard this post.

I have just undergone gut-wrenching and extensive therapy since December 2020 which for me had its origins in treatment I received as a small child of about 6.

I have been clinging to the earth these last few weeks so as not to slip again into the abyss where for some extended period of time a portion of my psyche had been living.

According to my own assessment, I have successfully crawled and clawed my way out of a 100 foot deep pit with slippery mud sides.

Now that I am completely out of the pit ( I hope), I am wondering what to do with myself, what to work on, what to avoid, what to learn, what to enjoy. Take a shower and wash off the mud? Take into account exactly where the pit is so as not to fall into it again? Designate this exit from the abyss as my new “rock bottom” and be thankful for hitting it so as to get the $%^&* out of there? Allow myself to tell myself, I deserve happiness? I deserve good health and fitness?

As fodder for knowing I have exited the abyss, for the first time in 20 years I have been able to stick to an exercise routine composed of mostly yoga and some walking in the neighborhood. I have recorded a log which is two weeks long and growing which for me is super progress. In my youth I was very, very fit, so getting back to that place with mindfulness is huge for me.

So if anyone here or there has also climbed out of their own pit of abuse or anxiety or depression, I would love to hear your story as to what you decided to do next once you found yourself alongside the edge of that pit but no longer in it.

Of course I will talk my therapist about it, but I thought I would ask you dear reader in the meantime.

My Sojourn through Bipolar Illness – Imprinting (reposted and a continuation from prior post)

What I took away from this first break experience during my Senior winter at Ivy College is that being mentally ill meant I was first a criminal and second a person. I know that first responders were doing their jobs to watch out for the safety of all those who were boarding the plane and/or in the airport. But that experience told me: “You are a criminal. You were trying to bomb the plane. You are guilty of anything and everything until proven innocent. You need to be handcuffed. You do not have the right to have fears much less to express them. You do not have the right to have perceptions that are not 100 percent clear. You are a danger to others around you and you need to be locked up.”

My first episode imprinted me for the rest of my life. For years, I would try to escape the label of criminal that had been imposed on me by circumstance and happenstance. But try as I might, I still felt like I was a criminal every time I had a subsequent break-through episode no matter how big or how small.

In hindsight, things could have unfolded quite differently. I could have reported to the school clinic that I was having anxiety about traveling to Chicago and had been having some trouble sleeping. I could have gone into the clinic for a routine evaluation and perhaps been put on lithium or some other drug for bipolar. But sadly, that is not the way my first episode and subsequent diagnosis of bipolar went. I remember to this day looking at those pictures on the wall in the police station and thinking they must be looking for me as “most wanted.” Being mentally ill simply meant I was a criminal.

I will talk later on about stigma and first responders — including the importance of training first responders how to recognize the signs if a person is a danger to him or herself or whether the person is also a danger to those around him or her. But that discussion about stigma and first responder training is for another day.